Abstract

Poor patient compliance with peritoneal dialysis (PD) has significant adverse
effects on morbidity and mortality rates in individuals with chronic kidney disease
(CKD). It also adds to the resource burdens of healthcare services and providers.
This paper explores the notion of PD compliance in patients with CKD with
reference to the relevant published literature. The analysis of the literature reveals
that ‘PD compliance’ is a complex and challenging construct for both patients
and health professionals. There is no universal definition of compliance that is
widely adopted in practice and research, and therefore a lack of consensus on
how to determine ‘compliant’ patient outcomes. There are also multiple and
interconnected determinants of PD compliance that are context-bound, which
healthcare professionals must be aware of, and which makes producing consensus
of measuring PD compliance difficult. The complexity of the interventions
required to produce even a modest improvement in PD compliance, which are
described in this paper, are significant. Compliance with PD and other treatments
for CKD is a multidimensional, context-bound concept, that to date has tended
to efface the role and needs of the renal patient. We conclude the paper with the
implications for contemporary practice.

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